| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
200 |
190 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
161 |
148 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$344.96 |
| 90686 |
|
15 |
15 |
$180.30 |
| 96127 |
|
29 |
26 |
$59.76 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$7.43 |
| 99000 |
|
12 |
12 |
$0.00 |